scholarly journals High signal intensity on T1 weighted MRI of the anterolateral column of the spinal cord in amyotrophic lateral sclerosis.

1997 ◽  
Vol 62 (1) ◽  
pp. 88-91 ◽  
Author(s):  
M Waragai ◽  
H Shinotoh ◽  
M Hayashi ◽  
T Hattori
Keyword(s):  
Spinal Cord ◽  
Amyotrophic Lateral Sclerosis ◽  
Signal Intensity ◽  
High Signal Intensity ◽  
High Signal ◽  
Lateral Sclerosis

scholarly journals Two Cases of Probable Neuro-Behçet’s Disease with Longitudinally Extensive Transverse Myelitis

2021 ◽  
pp. 78-83
Author(s):  
Shunya Fujiwara ◽  
Yasuhiro Manabe ◽  
Yumiko Nakano ◽  
Yoshio Omote ◽  
Taijun Yunoki ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Signal Intensity ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Transverse Myelitis ◽  
High Signal Intensity ◽  
High Signal ◽  
Longitudinally Extensive Transverse Myelitis ◽  
Behcet's Disease ◽  
Extensive Transverse Myelitis

We report 2 cases of probable neuro-Behçet’s disease (NBD) with longitudinally extensive transverse myelitis (LETM). In both cases, the patients presented paraplegia, as well as sensory, bladder, and rectal disturbances. Magnetic resonance imaging (MRI) of patient 1 showed continuous high signal intensity extending from the midbrain to the entire spinal cord in the central part of the cord on T2-weighted imaging (T2WI). Spinal MRI of patient 2 revealed high signal intensity extending from Th2 to Th10 in the central part of the cord on T2WI. Both patients received high-dose methylprednisolone. A continuous lesion from the midbrain to the entire spinal cord as in patient 1 has not been previously reported. Patient 2 dramatically improved by infliximab therapy. The present cases suggest that NBD should be considered as a differential diagnosis in patients with LETM.

Long-term surgical outcome and risk factors in patients with cervical myelopathy and a change in signal intensity of intramedullary spinal cord on magnetic resonance imaging

2010 ◽  
Vol 12 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Mitsuru Yagi ◽  
Ken Ninomiya ◽  
Michiya Kihara ◽  
Yukio Horiuchi
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Signal Intensity ◽  
High Signal Intensity ◽  
High Signal ◽  
Recovery Ratio ◽  
Mr Images ◽  
The Mean ◽  
High Signal Intensity Area

Object The goal of this study was to determine the long-term clinical significance of and the risk factors for intramedullary signal intensity change on MR images in patients with cervical compression myelopathy (CCM), an entity most commonly seen with cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament (OPLL). Methods One hundred seventy-four patients with CCM but without cervical disc herniation, severe OPLL (in which the cervical canal is < 10 mm due to OPLL), or severe kyphotic deformity (> 15° of cervical kyphosis) who underwent surgery were initially selected. One hundred eight of these patients were followed for > 36 months, and the 71 patients who agreed to MR imaging examinations both pre- and postsurgery were enrolled in the study (the mean follow-up duration was 60.6 months). All patients underwent cervical laminoplasty. The authors used the Japanese Orthopaedic Association (JOA) score and recovery ratio for evaluation of pre- and postoperative outcomes. The multifactorial effects of variables such as age, sex, a history of smoking, diabetes mellitus, duration of symptoms, postoperative expansion of the high signal intensity area of the spinal cord on MR imaging, sagittal arrangement of the cervical spine, presence of ventral spinal cord compression, and presence of an unstable cervical spine were studied. Results Change in intramedullary signal intensity was observed in 50 of the 71 patients preoperatively. The pre- and postoperative JOA scores and the recovery ratio were significantly lower in the patients with signal intensity change. The mean JOA score of the upper extremities was also significantly lower in these patients. Twenty-one patients showed hypointensity in their T1-weighted images, and a nonsignificant correlation was observed between intensity in the T1-weighted image and the mean JOA score and recovery ratio. The risk factors for signal intensity change were instability of the cervical spine (OR 8.255, p = 0.037) and ventral spinal cord compression (OR 5.502, p < 0.01). Among these patients, 16 had postoperative expansion of the high signal intensity area of the spinal cord. The mean JOA score and the recovery ratio at the final follow-up were significantly lower in these patients. The risk factor for postoperative expansion of the high signal intensity area was instability of the cervical spine (OR 5.509, p = 0.022). No significant correlation was observed between signal intensity on T1-weighted MR images and postoperative expansion of the intramedullary high signal intensity area on T2-weighted MR images. Conclusions Long-term clinical outcome was significantly worse in patients with intramedullary signal intensity changes on MR images. The risk factors were instability of the cervical spine and severe ventral spinal compression. The long-term clinical outcome was also significantly worse in patients with postoperative expansion of the high signal intensity area. The fact that cervical instability was a risk factor for the postoperative expansion of the high signal intensity indicates that this high signal intensity area occurred, not only from necrosis secondary to ischemia of the anterior spinal artery, but also from the repeated minor traumas inflicted on the spinal cord from an unstable cervical spine. The long-term neurological outcome found in the preliminary study of patients with CCM who had cervical instability and intramedullary signal intensity changes on MR images suggests that surgical treatment should include posterior fixation along with cervical laminoplasty or anterior spinal fusion.

scholarly journals Establishment of a nomogram for predicting the surgical difficulty of anterior cervical spine surgery

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chengyue Ji ◽  
Yuluo Rong ◽  
Jiaxing Wang ◽  
Guoyong Yin ◽  
Jin Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Signal Intensity ◽  
High Signal Intensity ◽  
High Signal ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Surgical Difficulty

Abstract Background For a long time, surgical difficulty is mainly evaluated based on subjective perception rather than objective indexes. Moreover, the lack of systematic research regarding the evaluation of surgical difficulty potentially has a negative effect in this field. This study was aimed to evaluate the risk factors for the surgical difficulty of anterior cervical spine surgery (ACSS). Methods This was a retrospective cohort study totaling 291 consecutive patients underwent ACSS from 2012.3 to 2017.8. The surgical difficulty of ACSS was defined by operation time longer than 120 min or intraoperative blood loss equal to or greater than 200 ml. Evaluation of risk factors was performed by analyzing the patient’s medical records and radiological parameters such as age, sex, BMI, number of operation levels, high signal intensity of spinal cord on T2-weighted images, ossified posterior longitudinal ligament (OPLL), sagittal and coronal cervical circumference, cervical length, spinal canal occupational ratio, coagulation function index and platelet count. Results Significant differences were reported between low-difficulty and high-difficulty ACSS groups in terms of age (p = 0.017), sex (p = 0.006), number of operation levels (p < 0.001), high signal intensity (p < 0.001), OPLL (p < 0.001) and spinal canal occupational ratio (p < 0.001). Multivariate logistic regression analysis revealed that number of operation levels (OR = 5.224, 95%CI = 2.125–12.843, p < 0.001), high signal intensity of spinal cord (OR = 4.994, 95%CI = 1.636–15.245, p = 0.005), OPLL (OR = 6.358, 95%CI = 1.932–20.931, p = 0.002) and the spinal canal occupational ratio > 0.45 (OR = 3.988, 95%CI = 1.343–11.840, p = 0.013) were independently associated with surgical difficulty in ACSS. A nomogram was established and ROC curve gave a 0.906 C-index. There was a good calibration curve for difficulty estimation. Conclusion This study indicated that the operational level, OPLL, high signal intensity of spinal cord, and spinal canal occupational ratio were independently associated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.

scholarly journals Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery

2021 ◽  
Author(s):  
Chengyue Ji ◽  
Yuluo Rong ◽  
Jiaxing Wang ◽  
Guoyong Yin ◽  
Jin Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Signal Intensity ◽  
High Signal Intensity ◽  
High Signal ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Surgical Difficulty

Abstract Background. For a long time, surgical difficulty is mainly evaluated based on subjective perception rather than objective indexes. Moreover, the lack of systematic research regarding the evaluation of surgical difficulty potentially has a negative effect in this field. This study was aimed to evaluate the risk factors for the surgical difficulty of anterior cervical spine surgery (ACSS).Methods. This was a retrospective cohort study totaling 291 consecutive patients underwent ACSS from 2012.3 to 2017.8. The surgical difficulty of ACSS was defined by operation time longer than 120 min or intraoperative blood loss equal to or greater than 200ml. Evaluation of risk factors was performed by analyzing the patient’s medical records and radiological parameters such as age, sex, BMI, number of operation levels, high signal intensity of spinal cord on T2-weighted images, ossified posterior longitudinal ligament (OPLL), sagittal and coronal cervical circumference, cervical length, spinal canal occupational ratio, coagulation function index and platelet count.Results. Significant differences were reported between low-difficulty and high-difficulty ACSS groups in terms of age (p=0.017), sex (p=0.006), number of operation levels (p<0.001), high signal intensity (p<0.001), OPLL (p<0.001) and spinal canal occupational ratio (p<0.001). Multivariate logistic regression analysis revealed that number of operation levels (OR=5.224, 95%CI=2.125-12.843, p<0.001), high signal intensity of spinal cord (OR=4.994, 95%CI=1.636-15.245, p=0.005), OPLL (OR=6.358, 95%CI=1.932-20.931, p=0.002) and the spinal canal occupational ratio>0.45 (OR=3.988, 95%CI=1.343-11.840, p=0.013) were independently associated with surgical difficulty in ACSS. A nomogram was established and ROC curve gave a 0.906 C-index. There was a good calibration curve for difficulty estimation.Conclusion. This study indicated that the operational level, OPLL, high signal intensity of spinal cord, and spinal canal occupational ratio were independently associated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.

Spinal Dural AVF Two Cases with MRI Follow-up

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 207-212
Author(s):  
S. Nishi ◽  
N. Hashimoto ◽  
I. Nakahara ◽  
T. Iwama ◽  
M. Sawada ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Early Diagnosis ◽  
Signal Intensity ◽  
High Signal Intensity ◽  
Gait Disturbance ◽  
Diagnosis And Treatment ◽  
High Signal ◽  
Common Trunk ◽  
Spinal Dural Arteriovenous Fistula

Spinal dural arteriovenous fistula (d-AVF) is one of the arteriovenous malformations that are treatable by surgery or embolization. We present two cases treated by embolization and stress the necessity of early diagnosis and treatment, and the usefulness of T2WI on MRI for follow-up after embolization. One was a 51-year-old man who presented with gait disturbance and sphincter dysfunction. MRI revealed diffuse swelling on T1WI, and intramedullary high signal intensity on T2WI. A spinal d-AVF was found through tiny radicullomeningeal arteries via the right Th12 intercostal artery that drained into engorged retromedullary veins. The spinal d-AVF was embolized with 50% NBCA. Six months after the embolization, he was able to go back to his job, T2WI showed disappearance of the high signal intensity, which was confirmed at angiography one year after the embolization. The other case was a 62-year-old man who presented with sensory disturbance and gait disturbance, MRI showed the same findings, without the flow voids on them in case 1. The high signal area in the central spinal cord was thought to be syringomyelia, in which a syrinx-subarachnoid shunt was tried in vain. On the surface of the spinal cord, abnormally engorged and tortuous vessels were found. The syrinx was not confirmed. An angiogram showed a spinal d-AVF fed by the radicullomeningeal artery through a common trunk of the Th11/12 intercostal arteries with drainage into the retromedullary vein. The spinal d-AVF was embolized. Six months after the embolization, T2WI showed a decrease of high intensity areas. Early diagnosis and treatment are important for the prognosis of spinal d-AVF, T2WI may be the best way to check for recurrence.

scholarly journals Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery

2020 ◽  
Author(s):  
Chengyue Ji ◽  
Yuluo Rong ◽  
Jiaxing Wang ◽  
Guoyong Yin ◽  
Jin Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Signal Intensity ◽  
High Signal Intensity ◽  
High Signal ◽  
Cervical Spine Surgery ◽  
Anterior Cervical Spine Surgery ◽  
Surgical Difficulty

Abstract Background. For a long time, surgical difficulty is mainly evaluated based on subjective perception rather than objective indexes. Moreover, the lack of systematic research regarding the evaluation of surgical difficulty potentially has a negative effect in this field. This study was aimed to evaluate the risk factors for the surgical difficulty of anterior cervical spine surgery (ACSS).Methods. This was a retrospective cohort study totaling 291 consecutive patients underwent ACSS from 2012.3 to 2017.8. The surgical difficulty of ACSS was defined by operation time longer than 120 min or intraoperative blood loss equal to or greater than 200ml. Evaluation of risk factors was performed by analyzing the patient’s medical records and radiological parameters such as age, sex, BMI, number of operation levels, high signal intensity of spinal cord on T2-weighted images, ossified posterior longitudinal ligament (OPLL), sagittal and coronal cervical circumference, cervical length, spinal canal occupational ratio, coagulation function index and platelet count.Results. Significant differences were reported between low-difficulty and high-difficulty ACSS groups in terms of age (p=0.017), sex (p=0.006), number of operation levels (p<0.001), high signal intensity (p<0.001), OPLL (p<0.001) and spinal canal occupational ratio (p<0.001). Multivariate logistic regression analysis revealed that number of operation levels (OR=5.224, 95%CI=2.125-12.843, p<0.001), high signal intensity of spinal cord (OR=4.994, 95%CI=1.636-15.245, p=0.005), OPLL (OR=6.358, 95%CI=1.932-20.931, p=0.002) and the spinal canal occupational ratio>0.45 (OR=3.988, 95%CI=1.343-11.840, p=0.013) were independently associated with surgical difficulty in ACSS. A nomogram was established and ROC curve gave a 0.906 C-index. There was a good calibration curve for difficulty estimation.Conclusion. This study indicated that the operational level, OPLL, high signal intensity of spinal cord, and spinal canal occupational ratio were independently associated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.

Sign in / Sign up

Export Citation Format

Share Document